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1、NursingManagementoftheAdultPatientwithNeurologicalAlterationsPreparedby:HikmetQubeilat.RN,MSC.BrainNeeds…BloodflowGlucoseOxygenDiagnosticStudiesSkullandSpinalRadiologyCT(ComputerizedTomography)MRI(MagneticResonanceImaging)PET(PositronEmissionTomography)EEG(Electroencephalogram)EMG(Electromyelo
2、gram)CerebralBloodFlowStudiesNeurologicalAssessmentLevelofConsciousness(LOC)PupilsVitalSigns(VS)NeuromuscularstatusResponsetostimuliPosturingGlasgowComaScale(GCS)I.NeurologicalDisordersThenormalfunctioningoftheCNScanbeaffectedbyanumberofdisorders,themostcommonofwhichareheadaches,tumors,vascula
3、rproblems,infections,epilepsy,headtrauma,demyelinatingdiseases,andmetabolic&nutritionaldiseases.HeadachesClassifiedbasedoncharacteristicsoftheheadacheFunctionalvs.OrganictypeMayhavemorethanonetypeofheadacheHistory&neurologicexamdiagnostickeysNotalwayschronic…becarefulPatternTensionMigraineClus
4、terSiteBilateral,basilar,band-likeUnilateral,anteriorUnilateral,occularQualitySqueezing,constantThrobbingSeverePatternCycles,yearsPeriodic,yearsRemitting,relapsingDurationDays,weeks,monthsHours,days30-90minOnsetAnytimeProdrome,startsinAMNocturnalAssoc.S&SStiffneckN&V,photo/phono-phobiaHornersy
5、ndromeONSET:NotreliableordiagnosticHA:EssentialHistoryOnsetthisparticularheadacheCharacterofpain,severityanddurationAssociatedsymptomsPriorhistory,patternOriginalonset:priortesting,treatmentOthertherapeuticregimensPhysicalExamNeurologicexaminationInspectforlocalinfections,nuchalrigidityPalpati
6、onfortenderness,bonyswellingsAuscultationforbruitsovermajorarteriesOrganicvs.Traumaticvs.Functional:DiagnosticsCBC:underlyingillness,anemiaChempanel:ifassociatedvomiting,dehydratedCTscan:forfocalneurologicalsigns,sinusNoLPforsuspectedICP;↑associationwithbrainherniationDon’tMissItCausedbysubara
7、chnoidhemorrhagefromananeurysmorheadinjury“Worseheadacheofmylife”ChangesinLOC,focalneurologicalsignsHighlycorrelatedwithCVAUntreated,50%mortalityHeadacheTeachingGuideKeepacalendar/diaryAvoidtriggersMedications(purpose,sideeffects)Stress
